Thomas Kimble, MD, reviews potential cardiovascular risks associated with some contraceptives.
Jenna Beckham, MD, MSPH, FACOG: We just talked more about the higher BMIs and sort of the efficacy and safety. What do you think about some of the studies that have shown a higher risk of some cardiovascular complications in combined hormonal contraceptive use with higher BMI patients?
Thomas Kimble, MD: There are a lot of studies, some from the United States and North America; some of them are from Europe. One thing I always consider when I'm looking at these studies is where was the clinical trial done because we're talking about 2 very different populations. In the United States you tend to have a higher BMI. In Europe you tend to have higher smoking and some other risk factors as well, so we must take those things into consideration. There was a study on a contraceptive product that a lot of us got concerned about using several years ago and when we looked further at the data, when you excluded women who had other risk factors there wasn't much of a risk in developing thromboembolic events. That's what the concern was so you really must look at some of these studies and use your judgement, look at where it was done, who was the population, did they control for other risk factors and just something to think about.
Jenna Beckham, MD, MSPH, FACOG: Right and as we've said earlier, just remembering that each patient is unique and individual and take all that data and help it inform your counseling and that decision but some of these things can help you with some guidance but not necessarily means it's not something that your patient can use especially in the absence of other risk factors. Certainly, if there are more risk factors to consider then that changes the equation.
Transcript edited for clarity